colon cancer symptom : Colon Cancer

Also known as: Colorectal Cancer

What is it?
Colon cancer is one of the most preventable forms of cancer. It almost always starts with non-cancerous growths (called polyps) that develop on the lining of the colon and rectum. Polyps can become cancerous, but if they are found early through screening tests they can be removed and the cancer stopped before it even gets started.

How common is it?
The lifetime probability of an average person developing colorectal cancer is 6% (or about 1 in 20).

Colon cancer is the third most commonly diagnosed cancer in the United States in both men and women.

Colon cancer is the second leading cancer killer, right behind lung cancer.

More women than men will be diagnosed with and will die from colon cancer in the year 2000.

Who gets it?
Although colorectal cancer may occur at any age, more than 90% of these growths occur in people over the age of 40. The risk increases with age; most people diagnosed with the disease are in their 50’s or 60’s.

Certain conditions are associated with a higher risk including a family history of polyps or colorectal cancer; a personal history of breast, uterine, or ovarian cancer; and inflammatory bowel disease (ulcerative colitis or Crohn’s disease).

What are the symptoms?
Many polyps and cancers of the colon or rectum do not produce symptoms until they are fairly large. That is why it is recommended that screening for colorectal cancer should start before symptoms occur – while polyps, if present, are small.

The most common symptom is bleeding with bowel movements. Blood may be seen in the stool, toilet water, or on the toilet tissue.

Changes in bowel habits, such as new problems with persistent diarrhea or constipation may occur. The stool may look more narrow than usual.

Abdominal pain or unexplained weight loss may be symptoms that occur as the disease progresses.

How can colorectal cancer be prevented?
Recent research suggests that a high fiber, low-fat diet plays a role in prevention; how great a role it plays is unclear. Fiber helps to move waste through the colon and may even protect cells in the lining of the colon from developing into polyps. A good rule of thumb is that the average adult should consume at least 25 – 35 grams of fiber daily. This amount can be obtained by eating five half-cup servings of fruits and vegetables every day. For adults, adding a soluble fiber supplement is an easy and practical way to obtain the recommended daily intake of fiber.

Staying active and drinking at least 8 eight-ounce glasses of non-caffeinated fluid daily also is good for digestive health.

By following the recommended screening methods, many polyps and growths can be detected early. Finding and removing colorectal polyps with sigmoidoscopy and colonoscopy clearly reduces the risk of their development into cancers.

Diagnosis
Average risk:

Beginning at age 40, men and women who have none of the risk factors described above should be examined by their healthcare provider annually with a digital rectal examination and a test for blood in the stool.

At age 50 a flexible sigmoidoscopic examination of the lower bowel should be performed. With this procedure, a thin flexible tube is passed into the anal opening to look at the lower portion of the large bowel. Polyps or growths of this area can be identified and removed. Or

A colonoscopy should be done every 10 years. With this procedure, a thin flexible tube is passed into the anal opening to look at the entire large bowel. Polyps or growths of this area can be identified and removed. Or

A double contrast barium enema x-ray should be done every 5 – 10 years.

Increased risk:

When personal or family history indicates that you are at increased risk for colon cancer, beginning at age 40 or earlier, the following is indicated:

A total evaluation of the colon by colonoscopy at intervals determined by your healthcare provider. Or

A double contrast barium enema x-ray and a flexible colonoscopy as recommended by your healthcare provider.

Treatment
If the cancer is located in the last few inches of the rectum, there may be several ways to treat it. Larger, non-cancerous polyps may be removed through the anal opening. Most of the larger cancers are removed through an abdominal incision. Although the bowel is usually reconnected after surgery, removal of the entire rectum and anus may be necessary if the cancer is located very close to the anal opening. In this case a colostomy is created.

If the cancer is located higher up in the colon, surgical treatment may be recommended. An operation is usually performed through an abdominal incision. The section of bowel containing the cancer and the lymph nodes close to it are removed. In most cases, the bowel is reconnected so that normal bowel function is restored. If the cancer has spread to the lymph nodes or to other organs in the body, additional treatment such as chemotherapy or radiation therapy may be suggested.

What kind of surgeon can I talk with about removing colon cancer?
Colon and rectal surgeons are experts in the surgical and nonsurgical treatment of colon and rectal problems. They have completed specialized and advanced training in the treatment of colon and rectal problems in addition to full training in general surgery. In addition to treating benign colorectal problems, such as hemorrhoids, these specialists are experts in treatment of colon cancer. They also perform routine screening examinations and treat problems surgically, when necessary.

Penn State Milton S. Hershey Medical Center ©2004
This page was last updated on January 18, 2006